Horiuhi Takahiro, Nomura Jun, Okuda Mitsutaka, Ichinohasama Ryo
Department of Internal Medicine, Miyagi Cancer Center.
Rinsho Ketsueki. 2003 Sep;44(9):940-5.
The abscopal effect is characterized by the spontaneous regression of unirradiated tumors resulting from the effect of irradiation on remote tissue. We report a case of NK/T-cell lymphoma of the small intestine that achieved complete remission as a result of an abscopal effect. A 74-year-old Japanese woman was referred to our hospital because of ileus and suspected perforation of the gastrointestinal tract. An emergency operation was performed and a perforated ulcerative tumor in the small intestine and enlarged mesenteric lymph nodes were found. Histopathological examination of the resected small bowel showed infiltration of large lymphoid cells with irregular nuclei and they were positive for CD3, CD56, TIA-1 and granzyme B. Physical examination did not reveal any lymphadenopathy in the neck, axillary or inguinal regions, skin involvement or nasal infiltration. The CT scans revealed multiple tumors in her upper abdomen and an obstructing conglomerate of small intestinal tumors. The patient did not show any response to CHOP therapy and radiotherapy was delivered to the lower abdominal field for the treatment of the ileus at a total dose of 44 Gy. Two months after radiotherapy, abdominal CT scans showed the disappearance of not only the tumors in the irradiation field but also the upper abdominal tumors that had not been irradiated. The patient has remained in complete remission for 15 months.
远隔效应的特征是由于对远处组织的照射作用导致未受照射的肿瘤自发消退。我们报告一例小肠NK/T细胞淋巴瘤因远隔效应而实现完全缓解的病例。一名74岁的日本女性因肠梗阻和疑似胃肠道穿孔被转诊至我院。进行了急诊手术，发现小肠有一个穿孔性溃疡性肿瘤和肿大的肠系膜淋巴结。对切除的小肠进行组织病理学检查显示有核不规则的大淋巴细胞浸润，且它们CD3、CD56、TIA-1和颗粒酶B呈阳性。体格检查未发现颈部、腋窝或腹股沟区有任何淋巴结病、皮肤受累或鼻腔浸润。CT扫描显示其上腹部有多个肿瘤以及小肠肿瘤形成的梗阻性肿块。该患者对CHOP疗法无任何反应，为治疗肠梗阻对下腹部区域进行了放疗，总剂量为44 Gy。放疗两个月后，腹部CT扫描显示不仅照射野内的肿瘤消失，而且未受照射的上腹部肿瘤也消失了。该患者已完全缓解15个月。
